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VOLUME 32, ISSUE 06

LONG WORK HOURS, SLEEP AND SLEEP DISTURBANCE
Long Working Hours and Sleep Disturbances: The Whitehall II Prospective Cohort Study

Marianna Virtanen, PhD1; Jane E. Ferrie, PhD2; David Gimeno, PhD2,3; Jussi Vahtera, MD,PhD1; Marko Elovainio, PhD4; Archana Singh-Manoux, PhD2,5,6; Michael G. Marmot, MD,PhD2; Mika Kivimäki, PhD1,2

1Finnish Institute of Occupational Health, Helsinki, Finland; 2University College London, Department of Epidemiology and Public Health, London, UK; 3The University of Texas School of Public Health, Health Science Center at Houston, Division of Environmental and Occupational Health Sciences, San Antonio Regional Campus, San Antonio, TX; 4National Research and Development Centre for Health and Welfare, Helsinki, Finland; 5INSERM U687-IFR69, Villejuif, France; 6Centre de Gérontologie, Hôpital Ste Périne, AP-HP, Paris, France



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Study Objective: To examine whether exposure to long working hours predicts various forms of sleep disturbance; short sleep, difficulty falling asleep, frequent waking, early waking and waking without feeling refreshed.
Design: Prospective study with 2 measurements of working hours (phase 3, 1991–1994 and phase 5, 1997–1999) and 2 measurements of subjective sleep disturbances (phase 5 and phase 7, 2002–2004).
Setting: The Whitehall II study of British civil servants.
Participants: Full time workers free of sleep disturbances at phase 5 and employed at phases 5 and 7 (n = 937–1594) or at phases 3, 5, and 7 (n = 886–1510).
Measurements and Results: Working more than 55 hours a week, compared with working 35–40 hours a week, was related to incident sleep disturbances; demographics-adjusted odds ratio (95% CI) 1.98 (1.05, 3.76) for shortened sleeping hours, 3.68 (1.58, 8.58) for difficulty falling asleep; and 1.98 (1.04, 3.77) for waking without feeling refreshed. Repeat exposure to long working hours was associated with odds ratio 3.24 (1.45, 7.27) for shortened sleep, 6.66 (2.64, 16.83) for difficulty falling asleep, and 2.23 (1.16, 4.31) for early morning awakenings. Some associations were attenuated after adjustment for other risk factors. To a great extent, similar results were obtained using working hours as a continuous variable. Imputation of missing values supported the findings on shortened sleep and difficulty in falling asleep.
Conclusion: Working long hours appears to be a risk factor for the development of shortened sleeping hours and difficulty falling asleep.
Keywords: Work hours, sleep, insomnia, overtime work, prospective
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